In South Carolina, the wait for help fighting AIDS tops nation

Banner Staff

COLUMBIA, S.C. — HIV sufferer Deadra Lawson-Smith is still getting back on her feet after a battle with pneumonia that sent her to a hospital emergency room and kept her out of work for parts of the past two months.

The 44-year-old single mother’s health deteriorated because she couldn’t afford treatment for the virus that causes AIDS. Her insurer initially balked at paying her claims and the state didn’t pitch in to help pay for her medication.

Lawson-Smith is far from alone: Hundreds of sick people are waiting for financial assistance from South Carolina, which has the longest such waiting list in the nation and ranks ninth in the number of AIDS cases per capita. Since the list started in June, four people waiting for help have died.

“I just pray and get up every morning,” said Lawson-Smith, who went a year without treatment. “My system started breaking down.”

More than 15,000 South Carolinians have HIV or AIDS, and about 800 more are diagnosed every year. Residents without insurance who earn too much money to qualify for Medicaid turn to the AIDS Drug Assistance Program for help getting prescriptions filled.

But federal funding for the program hasn’t kept pace with demand, forcing the state to start a waiting list that has grown to 432 names and is expected to top 600 by July, said Lynda Kettinger, director of the STD/HIV Division at the state Department of Health and Environmental Control. The agency has helped most patients on the list get their medicines through other assistance programs, but that process is lengthy and the assistance temporary.

Now, some advocates and South Carolina lawmakers are fighting to pump $5 million in state money into the program to end the wait. It’s a massive increase compared to the $500,000 South Carolina has contributed in past years.

Though South Carolina’s typical contribution is not the smallest — some drug-assistance programs operate with no state money — it’s a fraction of neighboring North Carolina’s $12.1 million and Georgia’s $11.3 million, according to the National Alliance of State and Territorial AIDS Directors.

Advocates here argue the $5 million for prescriptions, plus another $3 million requested for doctor care, is a deal compared to the billions of dollars AIDS patients would cost the state in emergency medical visits and lost work time.

“Either pay and keep people healthy or pay when they’re in the hospital,” said Lawson-Smith, a peer advocate for the South Carolina HIV/AIDS Council who tries to educate people about the disease.

The stigma that continues to follow HIV and AIDS, particularly in the South, helps fuel the spread of the disease because people are afraid to talk and learn about it, said Bambi Gaddist, executive director of the council. The effect is felt hardest in the black community, which represents about 75 percent of the state’s HIV/AIDS cases.

Early diagnosis and treatment are key: It helps people live longer, stay healthy enough to work and get rid of the need for state and federal assistance, she said.

“We can no longer act like this is not happening,” Gaddist said. “We’re all paying the price. You may not be African American or living in poverty, but you are paying.”

The number of states with AIDS treatment waiting lists has fluctuated since the program’s creation in 1990, topping out at 11 states a couple of years ago, said Jennifer Kates, vice president and director of HIV policy at the Henry J. Kaiser Family Foundation.

As of last month, South Carolina was among three states and Puerto Rico unable to serve all those who applied for help. Puerto Rico’s waiting list ranked second with 126 names, followed by Montana with 22 and Alaska with 16, according to the national AIDS directors organization.

Leading lawmakers in South Carolina call the waiting list an embarrassment. Republican Rep. Dan Cooper, chairman of the House budget-writing committee, said lawmakers will likely fund at least part of the $8 million request.

Democratic Rep. Joe Neal, who is leading the legislative push, admits he didn’t know much about the disease until it killed a beloved cousin. He said he soon realized South Carolina wasn’t doing enough.

“Many legislators are unfamiliar with this disease in their own districts. They don’t see it. They don’t know many who have it,” Neal said. Also a pastor, he said churches have been “ominously silent” and have a responsibility to help remove its stigma and encourage people to get tested.

“We’re in the Bible Belt. There’s a tendency to say, ‘These people brought it on themselves,’” he said. “And it’s seen in many quarters as an African American problem, and I don’t think the connections have been made as to what that reality means in South Carolina’s future.”

(Associated Press)